Abstract
The realm of
sexuality is quite vast, with many individuals having different concepts of
what “normal” looks like with respect to human sexuality. Some are influenced
by their own experiences, family beliefs passed down over generations, from
religious definitions, and even by what culture deems as acceptable. Counselors
often work with clients who have a different background, which includes
sexuality. Multicultural competency spans more than where someone comes from,
their ethnic makeup, and their socioeconomic status; sexuality also plays a key
role in establishing who a person is, just as much as the aforementioned
aspects. This paper will identify some key sexuality topics, as well as how
counselors can help their clients when working with diverse clients.
Additionally, legal considerations for counselors will be addressed in regards
to sexuality issues.
Sources
of sexual information
A challenge faced by many of the
current generation stems from the plethora of sources available in which they can
gain information about society, sexuality, and culture. In the past, people
were more apt to share the outlooks and beliefs of their family and those in
their social circle. However, advances in technology have afforded individuals
to expand their horizon when it comes to sexuality, thus broadening the
definition of what is considered “normal” in society.
Many still receive their guidance on
appropriate sexual behavior from their religious affiliations. While turning to
faith may comfort some, it also can make others feel excluded. According to the
literature, a shift in acceptable sexual standards has swayed away from that of
which is associated with Biblical tradition (Williams, 2013). Within the Christian
faith, especially those who observe strict interpretation of the Bible,
sexuality that strays from heterosexual or sex for procreation reasons is
shunned. Sadly, such an outlook excludes many people, leading to an increase in
depression, guilt, anxiety and suicidal risk (Subhi & Geelan, 2012).
An additional influence into the
definition of sexual identity is geographic location, which is also a part of
one’s culture. One study found that sexual practices could be categorized by
either “good/normal” or “bad/abnormal,” based on Western cultural standards
(Morrison, Ryan, Fox, McDermott, & Morrison, 2008). The same study revealed
that in addition to the acceptable practices, there were differences between
what was deemed “normal” when it comes to gender, with male sexual practices
that include homosexual fantasy and submission to fall under the category of
“abnormal,” whereas the same was not found among female sexuality practices.
Geographic
location comes into play when analyzing the level of acceptance of practices
that are deemed “abnormal,” with the United States, Ireland, and Poland being
associated with conservative sexual practices. Canada, Norway and the Czech
Republic were reported as being more liberal when it comes to “abnormal” sexual
practices (Morrison, Ryan, Fox, McDermott, & Morrison, 2008). The most
sexual liberal, when compared to the United States, is Sweden, which reports a
more accepting stance on nudity, masturbation, and expressing a desire for sex,
including those that were deemed as “abnormal.”
Education
and exposure: Combating biases
Within the United States, many
receive their sexual education from uncomfortable school presentations, which
focus largely on either abstinence-only or abstinence-plus programs that stress
abstinence as the primary choice, but also provide information on condoms and
contraceptives (Haglund & Fehring, 2010). While the programs do provide
some information about sexual health, they often come up short when it comes to
the broad definition of sexuality. Many focus on safe sex, including condoms,
contraceptives, pregnancy, and sexually transmitted diseases (Kirby, Laris,
& Rolleri, 2007), leaving a large percentage of sexuality unaddressed.
The educational shortcoming is not
limited to those in the K-12 grades, as medical residents have also reported a
lack of formal education when it comes to sexual health practices. A lack of
education was found among the topics of non-Western cultures and homosexual
relationships, with less than 50% of medical schools in the United States and
Canada spending more than two hours on sexual health (Morreale, Arfken, &
Balon, 2010).
While many physicians and mental health care workers have
come to the consensus that sexuality plays a large role in the lives of their
patients (Morreale, Arfken, & Balon, 2010), the educational system does not
appear to mirror their sentiments. Individuals who identify as gay often report
feeling left out of the sexual education present in the educational system, and
are more prone to being the target of harassment (Sherblom & Bahr, 2008).
Just as sexual orientation seems to be missing from the
curriculum, so do many other aspects of sexuality, including sexual
dysfunctions. The lack of education regarding sexual dysfunction is not limited
to the K-12 area of knowledge, but it is also present at the physician level.
Formal education among physicians in the realm of sexual health is often just a
bare bones version, which ignores an aspect of life that has the ability to
affect the lives of their patients. Many physicians have reported being
uncomfortable discussing the topic of sexual issues with their patients (Foley,
Wittmann, & Balon, 2010). However, data suggest that physicians, who are
involved in continuing education and possess effective communication skills,
are more apt to speak to their patients about sexual health related topics
(Foley, Wittmann, & Balon, 2010).
Ethical
considerations and sexual issues
Personal beliefs are an important part of one’s identity,
but it is important for physicians and those in the mental health profession to
separate their personal beliefs from that of their client. Counselors are bound
to encounter clients who have a different cultural background, which makes
multicultural education, including sexual identity, an important part of
continuing education.
The American Counseling Association has set forth a code
of ethics for those in the counseling field to abide by, which includes several
references to cultural sensitivity. Specifically, Section A.4.b. addresses the
idea that counselors are to be aware of their own values, and being cognizant
of not imposing their own values onto their clients (ACA, 2005). Additionally,
if counselors find that they are unable to treat clients, they are to cease
treatment and offer referrals to other counselors that may be more adept within
the scope of practice, as noted in section A.11.b. (ACA, 2005).
Conclusion
The vast array of sexual issues that counselors may
encounter during their practice makes personal reflection and continued
education essential in providing quality services for clients. Cultural
influence regarding what is deemed “normal” can vary due to religion,
geographic region, and personal experiences, all of which contribute to an
individual’s identity, including their sexual identity. Being aware that people
vary within a culture is important for both those working in the mental health
field, and society as a whole.
**References Available Upon Request**
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